Mothers

While pregnant mothers often get plenty of attention, after the birth, most of this attention can be focused on the baby. Mothers can often neglect their own health and emotional well being.  Check out our Mum's Health and Mum's Emotions sections below for a bit of help for yourself.

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If you have just given birth – you have just been through a life-changing event, here’s how to cope with the first few days - read more

You’ve just been through a life-changing event.  Here’s how to cope with those first few days.

Your new body

It will take a while for things to get back to normal.  A postnatal body feels very different from a pregnant body.  Knowing what to expect can make things easier.

Lochia

After the baby is born, most women have a discharge called lochia, which is a bit like a period.  It may be heavy at first but gradually get lighter.  You may need to use two maternity-grade sanitary pads for the first few hours, then just one at a time.  The loss is bright red to begin with, then pinkish for a week, then brownish-yellowish-white.  If you pass blood clots of blood bigger than a 50 cent piece, tell your LMC, and save that pad in a plastic bag to show her when she calls.  It may be that not all of the placenta came away after the birth and some pieces were left behind.  Some bleeding may occur for 3-5 weeks following the birth.

Your lochia should not be very smelly.  If it is, discuss with your LMC as you may have an infection.

Afterpains

You may feel ‘afterpains’, like contractions, sometimes very strongly when you begin a breastfeed.  These can be particularly strong after second and subsequent babies.  Your LMC may suggest taking medication to help.  They only last for a few days and are a good sign that your uterus is shrinking back to its usual size.

A stitch in time

Stitches after a cut (episotomy) or tear, can feel quite uncomfortable for the first few days.  Try these tips:

  • eat a diet rich in fibre so that passing a motion is easy
  • keep the area clean and use soft tissues to pat the area dry
  • practise your pelvic floor muscle exercises
  • if they sting when you urinate, take a cup of warm water into the toilet with you and pour this over stitches as you go.  Or urinate in the shower or bath just before you get out!
  • if you are worried about opening your bowels for the first time (and we all are!) fold a clean sanitary pad in half and hold this on your stitches while you go.

Perineal pain

Even if you haven’t had a tear or a cut, your perineum may feel very bruised and sore.  If you find it uncomfortable to sit down, your LMC can give you a support cushion.  An ice pack – applied for short periods – can also ease the pain.  You will be encouraged to get up and move around as soon as possible, even if you have had a caesarean; being active leads to a quicker recovery.  If your stitches are smelly or seem to be oozing, ask your LMC to check them.  There could be an infection and you might need antibiotics.

Coping after a caesarean

If you’ve had a section, you may find your postnatal recovery is slower than that of other mothers.  No wonder – you’ve had major surgery.  You’ll have:

A cut – it may look enormous at first, but it will gradually shrink along with your abdomen and eventually fade from red to a thin, fine white line.  You may also have a drain in the cut, a catheter in your bladder and a drip in the back of your hand!  All these things will gradually be taken out over the next 24 hours or so, making you freer to enjoy your baby.  If you need to cough or pass wind, it can be very painful.  Hold a pillow or both of your hands over the wound while you do so.

Stitches – depend on the surgeon.  Some are absorbable, others need to be removed.

Pain relief – you may be given injections or it is often given via a pump or through your drip.  Alternatively, you may be given suppositories which are put in your back passage, every few hours.  They are very effective in keeping you pain-free and are not harmful if you’re breastfeeding.  Do tell your midwife or LMC if you’re still in pain – it’s important that you’re comfortable enough to cuddle and feed your baby.

Wind – the surgery will have disturbed your digestive system and you may have wind in the lower bowel.  Eat plenty of fruit and drink plenty of fluids to keep things moving – it will soon fade.  Some women find that peppermint tea also helps.  Avoid fizzy drinks.

Advice on the best way to move, lift and feed your baby – you may need to try various feeding positions until you find one that’s comfortable.  Midwives will help you with this.  Keep your circulation working while you’re in bed by wiggling your toes and circling your ankles.

Most mothers find the first few days quite hard but then things improve quickly.  You may go home after about four or five days.  See if your partner, or a friend can help out in the first few weeks at home.

Thinking of heading back to work? Here are a few helpful ideas to make that decision a wee bit easier - read more

It can be a hard decision to go back to work after having your baby.  Here are a few helpful ideas to make that decision a wee bit easier.

Find out about flexible working

Parents of children aged 16 and under, or those who have disabled children, can request a flexible working pattern. This can help you balance caring for your child with work. Your employer has a legal duty to consider the request and must reply to you in writing.

Investigate Childcare Options.

Nannies/Daycare/Kindy which is the right choice for you? 

Babysitters/Nannies

A child must not by law be left alone in the care of a person under 14 years of age (this includes a sibling.)

  • A personal recommendation for a sitter is usually best and ask for a reference.
  • Stay with your baby and minder while they get to know one another.
  • Ensure you leave explicit information regarding feeding, changing, sleep and how frequently to check baby.
  • Leave your contact phone numbers and emergency numbers.
  • Make sure your sitter knows how to get out in case of an emergency.
  • Set ground rules regarding use of telephone, computer and having friends round.
  • It is helpful if the babysitter has a first aid certificate.

Returning to work

If you were in paid employment prior to having your baby, you will probably have discussed your parental leave entitlements as they relate to your employment contract. See our Paid Parental Leave section for more details.

The childcare decision is never an easy one. Whoever you choose to care for your child, you must feel totally comfortable with your decision.

You will need to remember that many childcare centres and family day care schemes have long waiting lists, and options such as employing a nanny can be very time-consuming. Commonly asked questions regarding childcare include

  • What is the staff to child ratio in the centre (how many children does one staff member care for)?
  • Will my child be happy and well cared for?
  • What sort of interactions will my child have with the carer?
  • Will my child resent me not being there for him 24/7?
  • Can I call in any time unannounced and will I be made to feel welcome?
  • What childcare qualifications/skills does the carer possess?
  • What are the health policies for this childcare centre and are they adhered to?
  • What facilities and resources are available to help my child develop socially, creatively and developmentally?
  • If something goes wrong while he’s in care will I be contacted immediately?
  • Will they feed expressed breastmilk?

What about the cost of childcare?

Childcare can be very expensive. Make sure you know what entitlements you may claim.

New Zealand Family Assistance

The Inland Revenue Department website www.ird.govt.nz for Family Assistance provides detailed information about the payments available to you and your family. You can contact family Assistance by the free-call number 0800 227 773 (remember to have your IRD number handy) or www.smartstart.services.govt.nz.

Family Assistance is available as:

  • Family Support
  • In work payment
  • Family Tax Credit
  • Parental Tax Credit

Paid parental leave may also be an option for some families.  The amount you receive will depend on your total family income, and its source, and how many dependent children under 18 years of age are living with you. Each family situation is different and you should seek advice from IRD about your particular circumstances.

Childcare and OSCAR (Out of School Care and Recreation) subsidies are available, depending on your income. For information on Childcare Assistance 0800774004, or apply online.

www.workingforfamilies.govt.nz

If you are applying for Family Assistance for the first time you will need to provide the following information:

  • Details about the principal child carer
  • Your bank account details for payment
  • Details of children (names, DOB, IRD numbers)

So how do you make that decision?

  • Referrals – whatever childcare you are considering, referrals from friends and co-workers are the first and most reliable method.
  • Visits – take your child with you to visit child care providers in your area.
  • Spend time watching how the staff interact with the children.
  • Enquire about the routines and educational programmes they have in place.

As a parent, you know your child best. Use that knowledge. To select a child care setting that’s right for him, consider your child’s activity level, his need for social interaction, and tolerance to new routines.

  • Is your child adaptable, approaching new situations and new people with ease, or is he cautious and hesitant when faced with a new situation?
  • Would he be more relaxed in a large group of children providing lots of opportunities for social interaction, or in a smaller group setting which might be less overwhelming?

Sleep

Some children’s sleep-wake patterns adapt easily to a group schedule, while others’ do not. Parents should look for centres that offer:

  • individual schedules (vs group routines)
  • separate sleeping areas
  • appropriate lighting (dim), temperature (comfortable) and noise level (low).

Special Needs

  • Are staff members open and enthusiastic about accommodating your child?
  • Are staff trained and supported to accommodate children with special needs?
  • Is the setting (including playground) accessible to your child?
  • Do any books or toys feature children with special needs?
  • Are staff willing to help your child develop the skills that your family believe are important?

Legal Entitlement for Breaks

Make sure you know the latest entitlements for rest, food and breastfeeding at work. 

Employers must provide appropriate facilities and breaks for women who want to breastfeed at work. This can be unpaid or paid, depending on the workplace policy.

Employers have to give breastfeeding breaks and appropriate facilities for women who want to breastfeed or express milk for their babies at work or during the working day, where this is reasonable and realistic in the circumstances (taking into consideration the employer’s operational environment and the employer’s resources). The breaks are unpaid and in addition to rest and meal breaks (unless the employee and employer agree otherwise). If employers don’t do this, the Employment Relations Authority could make them comply or give them a penalty.

Providing appropriate facilities for breastfeeding in the workplace

The facilities for breastfeeding should be appropriate. This means different things depending on the industry, workplace and employer’s resources. Appropriate facilities shouldn’t have to be too expensive or complicated. In most cases, a woman just needs a private space with somewhere to sit, and maybe a power point and access to a fridge if she’s expressing milk.

Women who have one baby are nearly three times more likely to leak urine than women who have not had a baby - read more

Incontinence

Bladder control

Embarrassingly, 1 in 3 women who have had a baby wet themselves. Women who have one baby are nearly three times more likely to leak urine than women who have not had a baby.

Why does having a baby cause urine leakage?

When the baby moves down through the birth canal (the vagina), the canal is stretched. The nerves, ligaments and pelvic floor muscles that control the bladder opening (urethra), are also stretched.

This can lead to weakened muscles and less structural support around the bladder opening, resulting in less bladder control. The symptoms? Leaking urine with coughing, sneezing, lifting, exercise.

Is this leaking likely to go away by itself?

The leaking is not likely to go away unless you guard against further damage and exercise your pelvic floor muscles to help them to get their strength back. As you get older, your pelvic floor muscles will tend to get weaker.

If you do not get the muscle strength back after each baby you have, you are more likely to leak urine. Following menopause, there is a higher risk of having problems with urine leakage also.

How does my bladder work?

The bladder itself is a hollow, muscular pump. The bladder fills slowly from the kidneys. You should be able to hold on until there is about 300-400ml inside the bladder. The bladder closing muscles are called pelvic floor muscles. When you are ready, the pelvic floor muscles relax and the bladder squeezes the urine out. Then the same cycle begins over again.

What do my pelvic muscles do?

 These muscles do a number of things such as:

  • Help to close off the bladder, the vagina and the back passage (the anus).
  • Help to hold the bladder, the uterus and bowel in their proper place.

What happens if my pelvic floor muscles are weak after the birth?

  • You might leak urine when you cough, sneeze, lift, laugh or exercise.
  • You might not be able to control your wind (flatulence)
  • You might feel a sense of urgency when you need to empty your bladder or your bowel.

Prolapse

When one or more of your pelvic organs sag down into your vagina, this is called pelvic organ prolapse.  Prolapse is very common and happens to about one in ten New Zealand women. If you have a feeling of ‘something coming down’, you might have a prolapse. See your doctor if you are not sure about this.

How do I exercise my pelvic floor muscles properly?

Position: Sit upright on a chair with your back supported. Relax your abdomen and thighs. Breathe normally – your abdomen should gently rise and fall as you breathe.

Pelvic Floor Muscle contraction: Imagine – ‘squeezing around the vagina entrance and lifting the vagina up inside’ or ‘squeezing around the bladder outlet and lifting the bladder up ’Feel the pelvic floor lift.

At first, the movement that you feel may be very small.

If your muscles are weak, you may feel very little at all. Make sure you keep breathing. If you draw your abdomen in strongly or hold your breath, this will hinder your ability to contract your pelvic floor muscles.  Make sure that you do not have any downward movement of your pelvic floor when you try to do a squeeze and lift.  The lower part of your tummy muscles should gently pull in as you squeeze and lift your pelvic floor muscles.  You might like to use a hand mirror to see your pelvic floor muscles working if you feel comfortable doing this. You will see an inward movement of the perineal body (the area between the vagina opening and the anal opening).

If you have difficulty isolating a pelvic floor muscle contraction, try lying on your side. In this position, it is easier to relax your abdominal muscles and therefore easier to feel your pelvic floor muscles tighten.

Pelvic Floor Muscles exercise programme

Step One: Isolation.

It is important that you are correctly contracting your muscles. (see the steps above on how to exercise your pelvic floor muscles) it does not matter if you cannot hold your muscles for long or if they feel weak. The technique is the most important first step.

Step Two: Strengthen – gentle lifts

Positions: lying down or sitting

Begin by gently lifting and squeezing. See if you can hold for 1-2 seconds then build up to 5-10 seconds. This is a gentle lift, not a ‘hard/strong lift’. Once you can hold for longer, see if you can keep breathing while lifting your pelvic floor muscles.

Step Three: Strengthen – strong lifts

Positions; lying down, sitting, standing leaning forwards, straight back and with hands on a bench or table.

Once you are able to control gentle lifts, aim to lift your muscles more strongly. Focus on a quick and strong lift. You will not be able to hold as long as a gentle lift.

Aim to hold for 2-3 seconds then build up to 5 seconds. This will take time and remember to keep your technique correct. Watch that your abdomen does not ‘suck in’ strongly, however, the more strongly you contract your pelvic floor muscles the more you will feel your abdomen tighten but it should remain flat (not suck in or bulge out).

The following is a suggested guide for exercising your pelvic floor muscles.

Lift and hold strongly: 1-5 seconds

Let go completely and rest: 2-5-seconds

Repeat: 8-12 times

Do this routine 3 times per day, daily for up to 5-6 months or until you have reached your goal which could take more or less time.

Step Four: Maintenance

To maintain the good strength and function of your pelvic floor muscles, keep exercising them often by following the above routine 3 times per week aiming for strong lifts.

Throughout the day, think of doing gentle sustained lifts when you are feeding your baby, driving your car or when exercising. Balance type exercise is good for this. For example, sitting on an exercise ball or standing on one leg. Aim to feel your pelvic floor muscles automatically tighten as you keep your balance.

It is also recognised that general exercise is good for improving pelvic floor muscle function. Walking swimming or doing low impact exercise at the gym are beneficial.

Aim to control your weight to a level that suits your height and build. Being overweight can lead to decreased control over your bladder and/or bowel and may also weaken your pelvic floor muscles.

Step Five: Functional

This means to use your pelvic floor muscles during activities of each day especially those activities which may cause urine leakage.

For example:  Lift strongly before you cough, sneeze, laugh or lift your child. This is sometimes called ‘the knack’.

Relationships

Your perception of a continence problem may affect your personal and/or intimate relationships and how you feel about yourself. Pelvic floor muscles play an important role in bladder and bowel control and also affect sexual function and sensation. If resuming sexual activity is concerning you, talk about it to someone who is knowledgeable and sensitive to this aspect e.g., your GP or midwife. Unfortunately, this issue is frequently overlooked or considered unimportant.

How can I be sure that I have good bladder habits?

It is normal to:

  • Go to the toilet about 6-8 times each day. Try not to go “just in case”.
  • You should pass about 300-400ml each time you go to the toilet.
  • It is OK to get up once each night to pass urine. Try not to go just because you have to get up to the baby.

Try to:

  • Drink at least two litres of fluid each day, which is 6-8 cups at 250mls per cup. If you are breastfeeding you may need a few more cups per day. You should have mostly water in your total daily fluid intake. Eg. 4-6 cups of water and 2-4 other drinks.
  • Avoid too much caffeine or carbonated drinks, limit to 2-3 cups per day. That is coffee, tea, coke, other fizzy drinks. Try a herbal or fruit infusion tea.

You should ask for help if you notice any of the following:

  • Any leaking of urine that is not improving
  • Needing to go urgently to the toilet. Sometimes you may not be able to hold on and leak before you reach the toilet.
  • Burning or stinging as you pass urine.
  • Having to strain to start the flow of urine.
  • Blood in the urine.

Can constipation cause urine leakage?

Yes! Excessive straining to pass a bowel motion can weaken and damage the pelvic floor muscles and supporting ligaments of your pelvic organs. This includes the bladder and bladder outlet. With strong straining, the bladder is also forced downwards leading to an increased risk of urine leakage problems. Constipation can also give the sensation of needing to go frequently or urgently to pass urine. In severe constipation, the bladder outlet can get obstructed causing difficulty in passing urine. The urine flow may be ‘stop/start’, ‘slow and trickly’ or ‘hard to start’.

How can I avoid constipation?

  • Drink plenty of fluid (at least 2 litres per day) especially if you are breastfeeding.
  • Eat high fibre bread and breakfast cereals.
  • Eat fruit, three pieces each day. Include kiwifruit.
  • Use a natural fibre supplement – Eg. Metamucil, Benefiber or Phloe. You can get these from the supermarket or pharmacy. Psyllium husks are much cheaper (get these from a health food shop).
  • Vegetables and lentils or pulses are all high in fibre.
  • Sit correctly on the toilet to pass a bowel motion. Follow the instructions below:
  • When you sit on the toilet, raise your heels or put your feet on a low stool.
  • Keep your back straight as you lean forward slightly.
  • Relax your pelvic floor, and gently bulge your tummy. It feels like the beginning of when you bear down. You will feel the sides of your tummy bulge and the lower part of your tummy will bulge forwards slightly. (If you overstrain, you will feel your pelvis and back move backwards. That is – round your back. This is incorrect.)
  • Do not rush. Work with the natural urge to pass a motion. If you try and push and strain too much, this hinders effective and complete emptying.
  • When you have finished, tighten your pelvic floor muscles a few times while still sitting on the toilet.

Special notes:

  • Always use this sitting position. This is not just for when you have had a baby.
  • Normal frequency to pass a bowel motion is 3 times per day to once every three days and your bowel motion should be soft but formed like a sausage, not too hard and not too soft!
  • If you have some swelling and/or stitches in your pelvic floor area after having your baby, you may need to support your perineum while passing a bowel motion. With some toilet paper around your hand, place it over the area between the vagina opening and back passage as you pass a bowel motion.
  • If you having problems passing a bowel motion or with faecal leakage or uncontrolled wind (flatulence), let your GP or midwife know. They can advise you on what to do or refer you to a health professional.

 CHECKLIST TO KEEP YOUR PELVIC FLOOR IN CHECK

  1.  Maintain good bladder and bowel habits.
  2.  Learn how to exercise your pelvic floor muscles correctly and aim to strengthen them. When they are stronger, lift your pelvic floor muscles before you lift, cough, sneeze etc
  3.  Start some general low-impact exercise like walking. As time and energy allow try some other types of exercise.
  4.  Aim for a healthy body weight. It is normal to have put on weight after having a baby but don’t allow it to ‘hang around’ set goals of healthy eating and exercising to reach your ideal weight.
  5.  Avoid heavy lifting, straining and high-impact exercise.
  6.  Avoid prolonged periods standing or being upright especially in the early weeks and months post-partum.
  7. Have some rest periods for yourself and for your pelvic floor.

If you have trouble with your bladder or bowel do not despair! The chances for a cure for an incontinence problem are good if you seek the right advice. Enjoy your pregnancy and your baby. Both before and after your baby is born, remember that it is important to take care of yourself.

 Need Help?

For information on managing incontinence:

  • This might be your GP, your specialist or your midwife.
  • Speak with the healthcare professional who is helping you after the birth of your baby
  • Many local hospitals have continence advisors. Please phone the Bladder Help Line for a contact list or view at www.continence.org.nz

They can also provide you with the name of the physiotherapist nearest to you who has a special interest in helping women with pelvic floor problems.

Discuss continence with your health professional. You should ask each of your health professionals how any aspect of care during your pregnancy, delivery or post-natal period could affect your bladder or bowel control (e.g. epidural, induction, repair of episiotomy or tears). Consider this information when making any decisions regarding your pregnancy, delivery and after-care.

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Mum's Health

What about Mum’s health?

While pregnant mothers often get plenty of attention, after the birth, most of this attention can be focused on the baby. Mothers can often neglect their own health, perhaps because they don’t wish to bother others with their own problems. It takes a while for your body to adjust following childbirth. If you had a caesarean section you will also need time to recover from the effects of the operation.

Caring for children can be fun and rewarding, however babies need a lot of attention during the early weeks and this can make life tiring. Some of the following ideas may help:

  • trying not to expect too much from yourself. It may help to do what is essential and catch up later if or when you have more time and energy.
  • asking your partner, family and friends to help with housework and childcare. They often enjoy being needed and accepting offers of help may make life easier for you.
  • making time to relax, cuddle and play with your children.
  • resting and relaxing while your baby is sleeping.
  • trying not to over-tire yourself with visitors. Visitors may like to help you by making a drink, a meal or helping around the house
  • planning time out with your partner, family and friends, leaving your baby with someone you trust
  • talking about your feelings, with your partner, family, friends, or health professionals particularly if you are stressed or feeling depressed.
  • joining a local Plunket or parent group, which will give you the opportunity to meet, talk, share experiences and advice with others in your situation.

Out and About

You may feel isolated and lonely during the first few weeks at home with a baby, it may help to talk to others about how you are feeling. If you have made friends at antenatal classes or in the maternity unit, you may like to keep in touch. You could also meet other mothers at the Plunket clinic, or there may be a local mother-and-baby group you can join.

Early postnatal care

If your baby is born in a hospital, the length of time you spend there following the birth will vary depending on where you live and the type of birth you experienced.

Once you are at home, your midwife and later your Plunket nurse or other Well Child Health Provider will visit you to provide support and answer any questions or concerns.  You will soon learn to identify what the crying means, you cannot spoil a baby of this age.

Your Health

Your health professionals are concerned about your wellbeing as well as your baby’s, so do not hesitate to discuss your own concerns.

Parents Centre

Where’s the baby manual?!  Parents Centre run support groups and a range of early parenting programmes, including ‘Baby and You’ with advice and tips on surviving and enjoying those first months with your newborn.  Visit their website to enquire about a programme running at a Centre near you.

Eating well

Now, more than any time, is when you will need all the energy you can find. Eating well will be essential to help you through the busy days and sleep-interrupted nights with your new baby. While you are focusing on your baby’s needs, don’t overlook your own.

Be guided by your own appetite. You may find you are hungrier during the first few weeks or months of breastfeeding. There is a good reason for this – you are feeding you and your baby. You may also feel thirstier; partly having lost a good deal of the fluid accumulated during pregnancy, but also when breastfeeding. Drink according to your thirst.

As you are adapting to your new daily routine, try to include three meals and some nutritious snacks throughout the day to meet the nutritional needs of both your and your baby. Breakfast is often missed but vitally important to kick start the day. Nourishing snacks include:

  • bananas
  • yoghurt
  • sandwiches
  • fruit smoothies

If you are concerned about weight gained during pregnancy, don’t try to lose it all at once. Crash dieting is never a good approach; it will drain you of energy and can leave you short on essential vitamins and minerals. Extra weight often reduces naturally, particularly with breastfeeding. Keeping active will certainly help. Not only can it burn off any extra calories/kilojoules, but makes you feel good too.  A brisk walk in the fresh air with friends or family is ideal, as well as a chance for them to meet your new baby.

Supplements – Folic Acid

You will almost certainly have been advised to take a folic acid supplement of 0.8mg before and during pregnancy until about 14 weeks, to help prevent neural tube defects. Purchase from your chemist or on prescription as the dose is not guaranteed from other sources.  If you are planning on becoming pregnant again or could become pregnant, you will need to start taking a folic acid supplement. Apart from folic acid, try to avoid reaching for the supplements as an alternative to eating well; they can’t provide the building blocks of a good eating pattern. Foods high in folic acid include fruit, vegetables, bread, cereals and cooked dried beans. Only food can provide the energy and protein needed to fuel your new lifestyle.

Special diets

If you are on a special diet, including a vegetarian diet, discuss your eating pattern with your midwife, or visit a dietitian, to ensure your diet is adequate. Omitting whole foods, such as meat and fish can leave you short on iron and zinc; avoiding dairy foods will reduce calcium and vitamin D; and going ‘wheat-free’, i.e. bread and cereals can leave you low on fibre and many B vitamins.

Skin and hair

Any reddish ‘stretch marks’ on your breasts, thighs and abdomen will shrink and become paler with time.

6 Things You Need to Know About Stretch Marks

 

 

 

Stomach muscle tone can improve with time and exercise.

You may also find that your skin is not as clear as it was, but this problem will improve.

You may find that your hair is dry and falling out more freely than usual; this is caused by temporary hormone changes and will stop in time.

Vaginal bleeding/discharge

After the birth of a baby, it is normal to have a discharge from the uterus, which is called lochia. This usually starts bloodstained and gradually becomes lighter and brownish. You may find that bleeding increases temporarily when you become more active. It may continue for over 6 weeks after baby’s birth. If you are breastfeeding your baby, it is likely to stop earlier as the uterus returns to normal more quickly.

Pads are best used for at least six weeks after the birth, after that time you may prefer using tampons once you feel comfortable.

See your midwife if you have a sudden heavy loss of blood, there are clots, or if the bleeding is smelly within the first six weeks.

If you are breastfeeding your periods may return in the first few months or may not return for the time you are breastfeeding. If you are formula feeding, your period is likely to return in the first 1-3 months. The first periods are often irregular and may be heavier or lighter than your usual period as your hormone levels settle to their pre-pregnant state.

It is important for early detection of cervical cancer to have regular smears. Talk to your midwife or doctor about smears and when your next one is due.

Perineal discomfort

You may feel bruised and sore around the perineum (the area between the vagina and rectum) even if you experienced a normal birth.

Your midwife can advise on treatment to relieve perineal pain and on the best position to adopt when lying or sitting.

Having sex again

Many women do not enjoy sex for some months after the birth of a child. You may feel tired and be sore from the birth. Caring for your baby places demands on your time and energy.

It is important to talk to your partner about your feelings and help him understand that he is not being rejected if you do not feel like sex.

You may decide as a couple to find other ways of sharing your love, cuddling or a massage can be relaxing and loving. Sex may be uncomfortable at first, especially if you have had stitches. Lubricating jelly or a different position may help. If sex continues to be painful, talk to your doctor.

Some breastfeeding women find that milk leaks when having sex. This is quite normal, it may help to have a towel handy.

Remember, that once you start having sex after the baby’s birth, you may become pregnant before you have had a period.  You can discuss contraceptives with your midwife, doctor, or family planning clinic.  0800 372 5463

Postnatal exercises

Postnatal exercises may feel like the last thing you want to do. After childbirth, the pelvic floor is very often weakened. The pelvic floor is a “hammock” shape of muscles that sits between your coccyxbone (tail bone) and your pubic bone. These muscles are there to support your bladder and bowel. If, during childbirth, your pelvic floor is weakened there could be a tendency to leak urine especially when you jump, cough or sneeze. With regular pelvic floor exercises, most women manage to correct the problem. They will feel weak initially, but the more you do, the stronger the muscles will become. These exercises will help to prevent leaking urine.

The pelvic floor muscles are easily located-imagine you are desperate to pass urine or pass wind, the muscles you use to stop from leaking are the pelvic floor muscles.

  • Imagine you are stopping yourself from passing urine, you pull the pelvic floor muscles up and in.
  • Hold this position for the count of five, then release.
  • Repeat that as many times as you can throughout the day-aim for 50 times a day.
  • Try and remember to do them whenever you are on the phone

You can do pelvic floor exercise during ‘idle’ times throughout the day- on the phone, waiting in lines, at traffic lights, the supermarket queue, or when sitting down.

Abdominal muscles

To help strengthen your abdominal muscles kneel on all fours and, keeping your back flat, pull your tummy button in towards your spine. You should feel the muscles at the side of your abdomen tightening but your back should not move. Keep breathing normally. Repeat this eight to 10 times.

Care of your back

Take care with lifting, lift bending your knees rather than your back. Be careful doing exercises after the birth e.g. ‘cycling’ with both legs in the air, sit-ups or lifting both legs together while lying down are best avoided at present. These can damage your back.

Mum's Emotions

After having a baby, changes in your hormone levels may cause you to feel tearful, irritable, depressed and tired.  You may find you are very tired from looking after baby around the clock especially if you have older children.

The ‘Baby Blues’

Between three and five days after your baby’s birth, you may experience mild depression, feel tense, or tearful for no particular reason. This is common and often known as the ‘baby blues’. It is caused by postnatal hormone changes. It usually lasts for a few days and does not need treatment.

Postnatal depression

Often mothers suffer in silence thinking they are a ‘bad mother’ and feel they have to cope.  Most do not realise they are depressed.  Postnatal depression is an illness which can be treated.

The good thing is that these feelings are not here to stay.  You will get better gradually with the correct help.

Postnatal depression affects about one in ten mothers, and can occur at anytime during the first year. The risk is greater for mothers who have had severe ‘baby blues’, who have suffered from depression in the past, who do not have good support, or who have experienced a recent stressful event such as a trauma, bereavement or illness.

Mothers with postnatal depression often experience feelings of hopelessness and inadequacy that do not seem to improve. Some women may feel angry and irritated and do not understand why, others may feel tearful, alone, guilty and unsupported. Each woman’s experience of postnatal depression is different. Cultural background may also affect a woman’s experience of postnatal depression.

How do you know if you have postnatal depression?

One way is to ask yourself if any of the following describe how you are feeling:

  • I have been unable to laugh and seethe funny side of things.
  • I have not looked forward with enjoyment to things as I used to.
  • I have blamed myself unnecessarily when things went wrong.
  • I have often been anxious or worried for no good reason.
  • I have felt scared or panicky for no good reason.
  • Things have been getting on top of me lately.
  • I have been so unhappy that I have difficulty sleeping even when my baby is asleep.
  • I often feel sad or miserable.
  • I have been so unhappy that I have been crying.
  • The thought of harming myself or my baby has occurred to me.

If you think some of the above points sound as you are feeling a lot of the time, you may like to get support and help from your doctor, or other health professionals

Some suggestions that may help you to cope with postnatal depression:

  • talk with people you trust, friends, relatives, health professionals
  • discuss what community supports are available to you.
  • accept offers of help that you feel comfortable with
  • keep your workload and expectations of yourself manageable.
  • take each day one at a time, you will have good days and bad days.
  • eat well, even if you have little appetite, try eating small, frequent meals.
  • find ways to relax, e.g. listening to music, reading
  • get some exercise, maybe leaving baby with a friend or family member and going for a walk or taking baby for a walk.

Discuss with your doctor your options for care and possible medication for the illness.

Emotions

Some mothers fall in love with their babies immediately, but for others it takes a little longer. Both responses are normal. Maternal feelings grow as you get to know your baby.

Feelings of anxiety, irritability, having difficulty sleeping and a reduced appetite may occur before starting to feel depressed.

If you are worried about your feelings towards your baby, or fear that you or your partner might harm the baby, seek help at once. Talk to your midwife or other health professional. They will understand and can help you.

NEVER shake or smack your baby – if you feel you might harm your baby put her in a safe place and walk away for a short time. 

Dads can help!

  • make mum a warm drink
  • talk to, and cuddle the baby
  • fold the washing
  • fend off too many visitors
  • play with, or take out older children
  • do supermarket shopping
  • talk to, and cuddle mum
  • listen to mum

Exercise for mum

What about Mum?

This is a good time to start gentle, low impact exercise, preferably to music. If you go to a gym make sure you tell the instructor you recently had a baby. Perhaps you would prefer to meet with some of your antenatal group and exercise, or you might hire an exercise video/ DVD.

Swimming is a great exercise for general toning. Pilates and yoga have excellent exercises for realigning posture and strengthening pelvic muscles.

A good walk pushing the buggy will keep baby happy too!

Remember your partner! Make time for each other. If you have a reliable babysitter try and go out to a movie, dinner, doing something that you enjoyed together pre- baby times.

Remember those pelvic floor exercises

Tighten the muscles around your anus, vagina and urethra, and lift up inside as I if trying to stop passing wind and urine at the same time. It is very easy to bring other irrelevant muscles into play, so try to isolate your pelvic floor as much as possible by:

  • not pulling in your stomach.not squeezing your legs together.
  • not tightening your buttocks
  • not holding your breath.

Rest for few seconds then repeat them, slow and controlled each time.